Title

Neurokinin-1 Receptor Antagonist for the Treatment of Itch in EB Patients
A Phase 2 Trial of Neurokinin-1 Receptor Antagonist for the Treatment of Itch in Epidermolysis Bullosa Patients
  • Phase

    Phase 2
  • Study Type

    Interventional
  • Intervention/Treatment

    serlopitant ...
  • Study Participants

    14
Our goal is to determine whether daily oral administration of VPD-737 (5 mg) is effective and safe in treating moderate to severe pruritus in patients with Epidermolysis Bullosa (EB).
Itch is the most common complaint reported by patients with EB of all subtypes, and there is no current effective treatment. Itch often triggers scratching that creates new wounds and increases EB disease severity.

This study aims to target the physiological mechanisms of pruritus (itch) in patients with EB. Substance P is a major mediator of pruritus and binds to the receptor neurokinin-1 (NK1), which is expressed in the central nervous system and the skin.

VPD-737 (serlopitant), a novel drug that inhibits the NK1 receptor, has been shown to reduce severe itch in a previous study of 257 adult patients with chronic pruritus.

Each patient will be un-blinded individually after completing 3 months of study period.

All patients who complete the study will be offered a 2-month period on active drug. Patient who received active drug in the first period will be contacted and asked if they would like to continue on active drug for an additional 2 months.

Patients who received placebo in the first period will be contacted and asked if they would like to repeat the study on open label for 2 months.
Study Started
Aug 31
2016
Primary Completion
Jun 28
2018
Study Completion
Jul 27
2018
Results Posted
Jul 02
2019
Last Update
Mar 23
2020

Drug VPD-737

VPD-737 inhibits the receptor neurokinin-1.

  • Other names: Serlopitant

Other Placebo

Matching tablets to VPD-737 tablets without active drug

5 mg VPD-737 Experimental

5 mg tablets of VPD-737 to be taken daily by mouth for 56 days

Placebo Placebo Comparator

Placebo tablets to be taken daily by mouth for 56 days

Criteria

Inclusion Criteria:

Clinical diagnosis of Epidermolysis Bullosa (EB) and pruritus

Exclusion Criteria:

Chronic liver or renal disease

Summary

Double-blind, 5 mg VPD-737

Double-blind, Placebo

Open-label, 5 mg VPD-737 - 5 mg VPD-737

Open-label, Placebo - 5 mg VPD-737

All Events

Event Type Organ System Event Term Double-blind, 5 mg VPD-737 Double-blind, Placebo Open-label, 5 mg VPD-737 - 5 mg VPD-737 Open-label, Placebo - 5 mg VPD-737

Comparative Weekly Change in NRS Itch Score Over the 8-week Active Treatment Period

Determine the efficacy of Serlopitant compared with placebo on reducing EB-associated daily itch score as measured by patient self-reports using a numeric rating scale (NRS) for itch severity.The NRS is comprised of one item and represents the numbers 0 ("no itch") to 10 ("worst imaginable itch"). Because itch is subjective and can vary day to day, nightly NRS scores were recorded in patients' Itch Diaries. NRS recorded by subject daily, from screening visit through the end of the study. This study was designed to detect differences between the two treatment groups. The primary endpoint was the comparative weekly change in Numeric Rating Scale (NRS) itch severity score from baseline over 8 weeks; derived from a linear mixed effects model which utilizes observations from both the treatment and placebo groups to generate an interaction term of interest. Itch severity changes from day to day and this model can more appropriately report trends in patients' itch severity with treatment.

5 mg VPD-737

-2.0
score/week comparative change (Mean)
95% Confidence Interval: -5.0 to 0.0

Placebo

-1.0
score/week comparative change (Mean)
95% Confidence Interval: -7.0 to 1.0

Wound Healing Determination

Wound dimensions, including length, width, and area (in cm2), will be obtained using the Canfield system. Changes in dimensions between visits as well as changes in dimensions from baseline will be recorded. Overall mean % change from baseline is reported as the secondary endpoint.

5 mg VPD-737

154.54
percentage change (Mean)
Standard Deviation: 227

Placebo

38.39
percentage change (Mean)
Standard Deviation: 180

Change in Mean NRS Itch Score During Bathing/Dressing Changes

Itch is exacerbated by activities such as dressing changes or bathing. NRS itch score during bathing or dressing in the past 24 hours were collected. Numeric rating scale (NRS) for itch severity is comprised of one item and represents the numbers 0 ("no itch") to 10 ("worst imaginable itch"). This study was designed to detect differences between the two treatment groups. This secondary endpoint was the comparative change in Numeric Rating Scale (NRS) itch severity score during bathing/dressing changes from baseline over 8 weeks as determined by application of a linear mixed effects model.

5 mg VPD-737

-2.5
score on a scale (Mean)
95% Confidence Interval: -4.0 to 1.0

Placebo

-2.0
score on a scale (Mean)
95% Confidence Interval: -5.0 to 0.0

Total

14
Participants

Age, Continuous

25.2
years (Mean)
Standard Deviation: 10.2

EB wound size

34.2
mm^2 (Mean)
Standard Deviation: 48.3

NRS daily itch severity score

6.6
score on a scale (Mean)
Standard Deviation: 1.2

NRS itch severity during bathing/dressing change

6.1
score on a scale (Mean)
Standard Deviation: 1.9

Ethnicity (NIH/OMB)

Race (NIH/OMB)

Region of Enrollment

Sex: Female, Male

Double-blind

5 mg VPD-737

Placebo

Open-label

5 mg VPD-737

Placebo